Effective Management Of Heart Patients

Coaching Programs run by nurses and dieticians have been found effective in lowering total cholesterol levels, but further analysis has shown they work only when these health professionals are able to prescribe cholesterol-lowering drugs.

Researchers looked at a program in which patients received their medications from their physicians and were only "coached" by nurses and dieticians on factors aimed at improving their cardiovascular health. The research involved nearly 800 heart disease patients at six university hospitals. About half took part in the program and the other half did not. At a six-month follow up, patients in the program had lowered their cholesterol by 21 points, compared to just seven points for those who did not participate in the program.

The program appeared to achieve lower cholesterol levels among the patients by encouraging patients to adhere to dietary advice and take their cholesterol-lowering medications as prescribed. The beneficial effects also spilled over into other areas important in controlling heart disease. Patients taking part in the program achieved substantial improvements in blood pressure, body weight, body mass index, and dietary intake of total fat, saturated fat, cholesterol, and fiber. They exercised more, had a better sense of well-being and better mood. They also had fewer symptoms of chest pain and breathlessness.

Thus researchers say "There seems to be a need for interventions that go beyond the simple transfer of information and reminders. Education should be followed by empowerment and monitoring, with iteration of this process until the target risk factor level is achieved. This is a key feature of the Coach Program."

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